Facts for Policymakers: Treatable Causes of Disability

Depression in Children and Adolescents

About 2 percent of school-age children (i.e. children 6-12 years of age) appear to have a major depression at any one time. With puberty, the rate of depression increases to about 4 percent of this population experiencing major depression overall.

Overall, approximately 20 percent of youth will have one or more episodes of major depression by the time they become adults.

Depression Affects Children on Many Levels

When children are in a depressive episode they do less well at school, have impaired relationships with their friends and family, suffer emotionally, and have an increased risk for attempted and completed

Episodes of depression in children appear to last six to nine months on average but in some children they last for years at a time.

Consequences of Untreated
Mental Illnesses in Children

Suicide – 3rd leading cause of death in youth.

Imprisonment – 80 percent of youth entering the juvenile justice system have a diagnosable mental illness.

Foster care - It is estimated that 85 percent of children in foster care have an emotional disorder or substance abuse disorder.

School failure and drop-out at dramatically high rates.

Custody relinquishment - Families are often forced to give up custody of their child to the state to secure services.

Substance use as self-medication.

Social isolation from their peers.

When children are in a depressive episode they do less well at school, have impaired relationships with their friends and family, suffer emotionally, and have an increased risk for attempted and completed suicide.

There are two main groups of treatments for the depressed child with demonstrated evidence of efficacy: psychotherapy and medications.

Despite a number of studies, there is essentially no evidence to suggest that older-generation antidepressants work for depression in children or adolescents. There are, however, published studies finding efficacy for newer medications, known as SSRIs, in child and adolescent depression.

In the middle of 2003 there were FDA and pharmaceutical company reports of low but increased rates of impulsive/suicidal behaviors in depressed children who are taking anti-depressants.

While there were no completed suicides in these studies in any group, these findings are worrisome and demand attention to the question of whether or not some anti-depressants may increase the hazard of suicide.

Many children with depression may present suicidal tendencies prior to taking medications. Any warning about the increased risk of suicidal tendencies in children could be very dangerous, because it potentially confuses symptoms of severe mental illness with the effects of medication.